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General NPI Number Information
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NPI Number | 1205598505
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Entity Type | Individual
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Provider Name | RACHAEL CECELIA BROOKS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/13/2021
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Last Update Date | 12/14/2024
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Provider Practice Location Address
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Address Line | 2518 N MAIN ST
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City | MIAMI
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State | OK
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Zip | 74354-1602
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Country | US
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Telephone | 918-540-9077
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 142
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City | WELCH
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State | OK
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Zip | 74369-0142
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Country | US
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Telephone | 620-779-2621
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 200313
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License Number State | OK
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